7. Genitals-Female

To examine the infant female, the hips should be only partially
abducted, i.e., to approximately 45° from the horizontal with the infant
lying supine. Exaggerated abduction may cause the clitoris and labia
minora to appear more prominent, whereas adduction may cause the labia
majora to cover over them.

In extreme prematurity, the labia are flat
and the clitoris is very prominent and may resemble the male phallus. As
maturation progresses, the clitoris becomes less prominent and labia
minora become more prominent. Nearing term, both clitoris and labia
minora recede and are eventually enveloped by the enlarging labia majora.

The labia majora contain fat and their size are affected by intrauterine
nutrition. Over-nutrition may result in large labia majora earlier in
gestation, whereas under-nutrition, as in intrauterine growth
retardation or post-maturity, may result in small labia majora with
relatively prominent clitoris and labia minora late into gestation.
These findings should be reported as observed, since a lower score on
this item in the chronically stressed or growth retarded fetus may be
counter-balanced by a higher score on certain neuro-muscular items.